Oncologic Nursing Overview

Question 1

Tumor

Answer 1

AKA “Neoplasm”
Can be:
- Benign
- Malignant

Question 2

Cellular Differentiation Theory

Answer 2

• Benign growth patterns
  EXAMPLE:
  Hypertrophy (inc. in size of muscle cells)
  Hyperplasia (inc. cell production)
  Metaplasia (replacement of cell)
  Dysplasia (presence of abnormal cells)
• Precursor of cancer
  EXAMPLES:
  Anaplasia (loss of characteristics from a normal cell)

Question 3

Differentiation: Well differentiated, structure may be typical of tissue of origin.

Rate of growth: Usually progressive and slow, it may come to a standstill or regress. Mitotic features are rare and normal.

Local invasion: Usually cohesive and expansive, well-demarcated masses that do not invade or infiltrate surrounding tissues

Metastasis: Abset

Answer 3

Benign Tumor

Question 4

Differentiation: Some lack differentiation with anaplasia, and structure is often atypical.

Rate of growth: Erratic and may be slow to rapid, mitotic figure may be numerous and abnormal

Local Invasion: Locally invasive; infiltrating surrounding normal tissues and sometimes may be seemingly cohesive and expansile

Metastasis: Present

Answer 4

Malignant Tumor

Question 5

Failure of the Immune Response Theory

Answer 5

Kaposi’s Sarcoma in HIV-AIDS Patients (cancer that develops from the cells that line lymph or blood vessels)

= LYMPHATIC SYSTEM: Acts as a ‘sewerage system’ and it is important for the optimal functioning of our general and specific immune responses.

Question 6

Tumor Type: Mesenchymal cells
Cell tissue of origin: Fibroblast, Fat cells, Bone cells

Answer 6

Benign Tumor: Fibroma, Lipoma, Osteoma
Malignant: Fibrosarcoma, Liposarcoma, Osteosarcoma

Question 7

Tumor Type: Epithelial tumor
Cell tissue of origin: Squamous epithelium, Glandular or Ductal epithelium

Answer 7

Benign Tumor: Epithelioma, Adenoma
Malignant: Squamous cell carcinoma, Adenocarcinoma

Question 8

Tumor Type: Internal organs
Cell tissue of origin: Liver cell

Answer 8

Benign Tumor: Liver cell adenoma
Malignant: Liver cell carcinoma

Question 9

Tumor Type: Germ cell tumors
Cell tissue of origin: Embryonic cells

Answer 9

Benign Tumor: Teratoma
Malignant: Embryonal carcinoma

Question 10

Initiation - exposure to initiating agents (carcinogens)

Promotion - carcinogens cause unregulated accelerated growth in previously initiated cells: reversible

Progression - tumor cells acquire malignant characteristics

Answer 10

Carcinogenesis

Question 11

Characteristics of Cancer Cells

Answer 11

• Altered cell differentiation
• Appearance changes
• Altered Metabolism
• Tumor-specific antigens “non-self”/ foreign material
• Altered cellular function

Question 12

Term for cancer cells varying in size and shape

Answer 12

Pleomorphism

Question 13

Term for an abnormal number of chromosomes

Answer 13

Aneuploidy

Question 14

Hallmark of cancer

Answer 14

Metastasis

Question 15

Cell Cycle

Answer 15

G1 - Growth
S - DNA Synthesis
G2 - Growth and preparation for mitosis
M - Mitosis (Cell division)

Question 16

What is the average doubling time for a solid tumor?

Answer 16

2 months

Question 17

A tumor that is 1 cm in size = 1 g in wt contains ___ cells

Answer 17

1 billion

Question 18

The ratio of the total number of cells to the number of dividing cells

Answer 18

Growth fraction

Question 19

Carcinogenic Factors

Answer 19

• Heredity
• Hormonal factors
• Bacteria and parasites
• Oncogenic viruses
• Environmental factors

Question 20

Route of spread

Answer 20

• Lymphatics
• Blood vessels
• Direct seeding (invading nearby normal tissue)

Question 21

Most common cancer in the Philippines

Answer 21

• Breast
• Lung
• Cervical
• Colorectal
• Prostate
• Adult leukemia
• Head and neck
• Thyroid

Question 22

Warning signs of cancer

Answer 22

C - Change in bladder or bowel habits
A - A sore/lesion that does not heal
U - Unusual bleeding or discharge
T - Thickening or lump (in the breast or elsewhere)
I - Indigestion or difficulty swallowing
O - Obvious changes in warts or moles
N - Nagging cough or persistent hoarseness

U - Unexplained anemia
S - Sudden weight loss

Question 23

Tumor Markers (Diagnostic Tests)

Answer 23

A. Prostate-specific antigen

B. S – 100 – melanoma cells

C. Thyroglobulin

D. CA 15 – 3 or CA 27 – 29: breast cancer

E. Carcinoembryonic antigen (CEA) or CA 19 - 9: colorectal cancer

F. CA 125: ovarian cancer

G. HCG: germ cell tumors

H. AFP (Alpha-fetoprotein): liver cancer

I. Beta 2 macroglobulin (B2M): multiple myeloma, lymphocytic leukemia, and some lymphomas

J. Chromogranin A (CgA): neuroendocrine tumors, most sensitive for carcinoid tumors

Question 24

Diagnostic Imaging

Answer 24

1. X-ray
2. Mammography
3. CT scan
4. Ultrasound
5. Nuclear medicine
6. Positron Emission Tomography
7. Lymphoscintigraphy
8. MRI

Question 25

Most definitive diagnostic test for cancer

Answer 25

Biopsy

Question 26

Endoscopy

Answer 26

- For diagnostic and therapeutic purposes - Bronchial - GI Cancer

Question 27

Utilizes invasive surgical techniques to actually visualize structures and assess the extent of the disease (Staging of Cancer)

Answer 27

Surgical Staging

Question 28

Based on professional judgment and measurement of the primary tumor’s size, location in the body, and evidence of the disease through physical examination

Answer 28

Clinical Staging

Question 29

The practice of examination of the tissue of interest both grossly and microscopically to evaluate its characteristics and make an assessment a to the aggressiveness of the malignant tumor

Answer 29

Pathological Staging

Question 30

The branch of medicine that uses manual and instrumental to deal with the diagnosis and treatment of injury, deformity, and disease

Answer 30

Surgery